# FATE-register: mislukte transkatheter-tricuspidalisreparatie (T-TEER)

*geplaatst 2026-03-23 · Hartfalen · JACC. Cardiovascular interventions · doi 10.1016/j.jcin.2026.01.285 · https://hartvaat.nl/2026/03/23/fate-register-mislukte-transkatheter-tricuspidalisreparatie-t-teer/*

Het internationale FATE-register onderzocht apparaat-gerelateerde mislukkingen van transkatheter edge-to-edge-reparatie van de tricuspidalisklep (T-TEER). Onder 2.278 ingrepen in 31 centra traden 123 mislukkingen op (5,4%; meestal eenbladige fixatie, 75%), vaak vroeg herkend en met ernstige restregurgitatie in 73%. Reïnterventie (bij 46%) gaf meer reductie van de tricuspidalisinsufficiëntie en gunstiger remodellering van het rechter atrium dan medicamenteuze therapie, maar het gecombineerde eindpunt van sterfte of hartfalenheropname bleef hoog (38%) en verschilde niet tussen beide strategieën. Een hogere TRI-SCORE, acute nierschade en ernstigere restregurgitatie voorspelden een ongunstige uitkomst.

## English: 

The international FATE registry examined device-related failures of transcatheter edge-to-edge tricuspid valve repair (T-TEER). Across 2,278 procedures at 31 centres, 123 failures occurred (5.4%; mostly single-leaflet device attachment, 75%), often recognised early and with severe residual regurgitation in 73%. Reintervention (in 46%) achieved greater tricuspid-regurgitation reduction and more favourable right-atrial remodelling than medical therapy, but the composite of death or heart-failure rehospitalisation remained high (38%) and did not differ between strategies. Higher TRI-SCORE, acute kidney injury and greater residual regurgitation predicted adverse outcomes.

## Abstract (original, from the publication)

BACKGROUND: Tricuspid regurgitation (TR) is linked to significant morbidity and mortality. Tricuspid transcatheter edge-to-edge repair (T-TEER) provides a less invasive option for high-risk patients, but real-world data on device failure mechanisms and outcomes remain limited. OBJECTIVES: The aim of this study was to investigate the incidence, management, and outcomes of T-TEER device-related failures due to loss of leaflet insertion, single-leaflet device attachment, or device embolization, offering insights into these adverse events. METHODS: The retrospective, multicenter FATE (Failed Tricuspid Transcatheter Edge-to-Edge) registry identified all device-related failures associated with moderate or greater residual or recurrent TR among 2,278 consecutive T-TEER procedures performed at 31 centers from 2017 to 2024. Failure mechanisms were classified by multiparametric echocardiography. Coprimary endpoints were the incidence and management of device-related failure and the composite of death or heart failure rehospitalization. RESULTS: Among 2,278 T-TEER procedures, 123 device-related failures (5.4%) were identified (loss of leaflet insertion, 24%; single-leaflet device attachment, 75%; embolization, 1%), mostly diagnosed early and associated with severe or greater TR in 73%. Management was medical therapy in 54% and reintervention in 46%. Reintervention achieved greater TR reduction and right atrial reverse remodeling than medical therapy, but over a median follow-up period of 255 days, the composite of death or heart failure rehospitalization remained frequent (38.2%) and did not differ between strategies. Higher TRI-SCORE, acute kidney injury, and greater discharge TR severity independently predicted adverse outcomes. CONCLUSIONS: Device-related failure after T-TEER is uncommon but clinically relevant. Reintervention achieves greater TR reduction and right atrial reverse remodeling than medical therapy, but events remain similar between both strategies.

Auteurs: Federico De Marco, Gianmaria Calamita, Valentina Ardizzone, Mirjam Gauri Winkel, Mohammad Kassar, Fabien Praz, Nicolas M Van Mieghem, Joris F W Ooms, Muhammed Gerçek, Felix Rudolph, Marianna Adamo, Augustin Coisne, Jérémie Arlanda, Philipp Lurz, Rodrigo Estévez-Loureiro, Neil P Fam, Joachim Schofer, Christina Brinkmann, Marina Urena, Gregory Ducrocq, Jan-Malte Sinning, Tobias Geisler, Alessia Azzano, Elvis Brscic, Antonella Millin, Azeem Latib, Maurizio Taramasso, Antonio Popolo Rubbio, Francesco Bedogni, Stephanie Brunner, Stefan Toggweiler, Martin J Swaans, Leo Timmers, Francesco Giannini, Alfonso Ielasi, Omar Oliva, Nicolas Dumonteil, Didier Tchetchè, Dabit Arzamendi, Giulia Maisero, Giuseppe Tarantini, Gabriele Crimi, Italo Porto, Fausto Castriota, Luca Ferri, Matteo Montorfano, Alessandro Sticchi, Maria Lopez-Laporte, David Messika-Zeitoun, Marino Labinaz, Peter Lüdike, Horst Sievert, Giulia Antonelli, Fabio Fazzari, Cristina Ferrari, Antonio Mangieri

---
Bron: JACC. Cardiovascular interventions, https://doi.org/10.1016/j.jcin.2026.01.285. Bijgewerkt 2026-07-03T13:31:15Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.